Volumizing thread lift for subzygomatic arch (lateral cheek) depression

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R E S E A R C H L E T T E R Volumizing thread lift for subzygomatic arch (lateral cheek) depression
Dear Editor, Subzygomatic arch depression frequently manifests in elderly individuals as a result of masseter muscle and fat atrophy. 1,2Nonetheless, this depression may also appear prominent in younger individuals with well-defined zygomatic arches.Literature on managing subzygomatic arch depression is sparse, leaving a gap in understanding optimal treatment approaches.Yi et al. 3 conducted a cadaveric study investigating hyaluronic acid (HA) filler injection for correcting subzygomatic arch depression and enhancing facial contours.While HA filler injection is a popular and minimally invasive method for such corrections, the conventional single-layer injection technique has limitations, including inadequate volume addition and potential for undesired undulations and spreading.The study provides anatomical guidance, suggesting the use of both hard-type and soft-type HA fillers injected into the sub-superficial musculo-aponeurotic system (SMAS) and subcutaneous fatty layers, respectively, to maximize correction.Notably, the subzygomatic region's robust and resilient retaining ligaments present challenges for achieving volumization solely through filler administration.[6] Our aim is to present a successful case of managing subzygomatic arch depression using volumizing thread lifts and to demonstrate the thread lift insertion technique (Figure 1) through a Video S1.
A 45-year-old patient presented with hollowing under the cheekbones, expressing concern about its aging effect on her appearance.The visual assessment revealed exaggerated subzygomatic arch depression.To address this, the correction was performed using an 18-gauge, 5 cm N-scaffold (N-finders, Korea).Thicker and firmer volume threads, such as the N-Scaffold (N-Finders, Korea), are typically employed for subzygomatic arch depression volumization.The patient underwent biweekly follow-ups for 1-month post-thread lift, during which no adverse events or complications were observed.A follow-up photograph was taken at the 1-month mark to assess the outcomes (Figure 2).

F I G U R E 1
To address subzygomatic arch depression, a correction was performed using an 18-gauge, 5 cm N-scaffold (N-finders, Korea).For subzygomatic arch depression, thicker and firmer volume threads are typically employed, and these can be volumized using N-Scaffold (N-Finders, Korea).fascia, and the masseter muscle.Using HA filler in this area poses a risk of vascular damage, especially around the superficial temporal artery and pretragal area. 36][7][8][9][10] In our clinical practice, we target age-related subzygomatic volume deficiency and atrophy, alongside subzygomatic depressions, in young Southeast Asian women.This treatment is designed to contour the oval face and diminish subzygomatic prominence through the use of volumizing thread lifts, aligning with the aesthetic preference for an oval face contour often desired by individuals of Southeast Asian descent. 11,12ts 13  The study highlights the effectiveness of PDO threads in stimulating collagen formation and repositioning tissue, which can be particularly beneficial for addressing subzygomatic arch depression.5][16] For instance, Kim et al. 17  In conclusion, our case presents the effectiveness of addressing subzygomatic arch depression through the application of volumizing PDO threads, showcasing it as an effective and safe technique in facial rejuvenation.The patient's satisfaction with the outcomes highlights the efficacy of this approach in achieving the desired aesthetic improvements.Further investigation is necessary to assess the long-term safety and effectiveness of PDO thread lift procedures for subzygomatic arch depression.
The patient expressed satisfaction with the results, both immediately post-procedure and during the 1-month follow-up, highlighting a preference for improved cheek contour and looking more refreshed.The subzygomatic region comprises the skin, a layer of subcutaneous fat, the SMAS, a sub-SMAS fatty layer, the parotidomasseteric This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2024 The Author(s).Skin Research and Technology published by John Wiley & Sons Ltd.
photography.Results indicated collagen formation around the threads, skin improvement, and sagging reduction.Physiological and morphological changes in facial aging were discussed alongside PDO compared the collagen-producing effects of powdered PDO with poly-L-lactic acid, finding that powdered PDO injections induce collagen formation more effectively in a murine model.